Assessing the Clinical Utility of the Question, "Is Your Child/Are You Back to Normal?" in Pediatric Concussion Symptom Resolution

Clin Pediatr (Phila). 2018 Feb;57(2):146-151. doi: 10.1177/0009922817693300. Epub 2017 Feb 15.

Abstract

This study investigates the relationship between the general question, "Is your child/are you back to normal?" and a validated postconcussive symptom scale when assessing symptom resolution following concussion. Children with acute concussion were enrolled during an emergency department visit. Sensitivity and specificity analyses compared the true/false question, "My child is/I am back to normal" at 3 days postinjury with the Concussion Symptom Inventory (CSI; gold standard). A total of 201 participants were enrolled in the study with complete data. The true/false questions of "My child is/I am back to normal" had sensitivities of 78.4% and 59.3% and specificities of 75.0% and 86.4% for caregiver and child responses, respectively, when compared with their corresponding CSI. This study demonstrates that asking a parent or child if the child is back to normal has poor sensitivity and modest specificity in determining if a child's symptoms have resolved within 3 days of sustaining a concussion relative to a standardized symptom scale.

Keywords: children; concussion; emergency department; mild traumatic brain injury; postconcussive syndrome.

Publication types

  • Comparative Study
  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Age Factors
  • Brain Concussion / diagnosis*
  • Brain Concussion / therapy
  • Caregivers
  • Child
  • Cohort Studies
  • Emergency Service, Hospital
  • Female
  • Glasgow Coma Scale
  • Humans
  • Male
  • Monitoring, Physiologic / methods*
  • Post-Concussion Syndrome / diagnosis*
  • Post-Concussion Syndrome / epidemiology
  • Prospective Studies
  • Recovery of Function / physiology*
  • Reference Values
  • Risk Assessment
  • Sensitivity and Specificity
  • Sex Factors
  • Surveys and Questionnaires / standards*
  • Time Factors